Adherence to combined lifestyle factors and their contribution to obesity in the IDEFICS study

Obes Rev. 2015 Dec:16 Suppl 2:138-50. doi: 10.1111/obr.12349.

Abstract

Background: The Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS (IDEFICS) study investigated the aetiology of childhood obesity and developed a primary prevention programme.

Methods: Pre-intervention adherence to key behaviours related to childhood obesity, namely water/sweetened drink, fruit/vegetable consumption, daily TV time, physical activity, family time and adequate sleep duration, was measured at baseline. Adherence to international recommendations was converted into a composite score ranging from 0 (none) to 6 (adhering to all). Data on adherence were available for 7,444 to 15,084 children aged 2-9.9 years, depending on the behaviour. By means of multi-level logistic regression models adjusted for age, sex and country, we calculated odds ratios (OR) and 95% confidence intervals (CI) to estimate the relationship between adherence to these recommendations and the risk of being overweight/obese.

Results: Adherence ranged from 15.0% (physical activity) to 51.9% (TV time). As adherence increased, a lower chance of being overweight/obese was observed; adhering to only one key behaviour (score = 1) meant an OR = 0.81 (CI: 0.65-1.01) compared with non-adherence (score = 0), while adhering to more than half of the key behaviours (score ≥ 4) halved the chance for overweight/obesity (OR = 0.54, CI: 0.37-0.80). Adherence to physical activity, TV and sleep recommendations was the main driver reducing the chance of being overweight. Overweight/obese children were more likely not to adhere to at least one of the recommended behaviours (19.8%) than normal-weight/thin children (12.9%)

Conclusion: The selected key behaviours do not contribute equally to a reduced chance of being overweight. Future interventions may benefit most from moving more, reducing TV time and getting adequate sleep.

Keywords: Children; diet; overweight; physical activity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Body Mass Index
  • Child
  • Child, Preschool
  • Diet
  • Drinking
  • Energy Intake
  • Europe / epidemiology
  • Female
  • Fruit
  • Health Behavior*
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Male
  • Patient Compliance
  • Pediatric Obesity / epidemiology
  • Pediatric Obesity / prevention & control*
  • Pediatric Obesity / psychology
  • Primary Prevention*
  • Risk Reduction Behavior*
  • Sleep
  • Time Factors
  • Vegetables
  • White People / statistics & numerical data